Alpha-Myosin
Function:
Myosin, the major contractile protein, converts chemical energy into mechanical force through hydrolysis of ATP. a-Myosin is almost exclusively expressed in cardiac tissue.
Antibodies Appear:
- Autoimmune Myocarditis [3]
- Dilated Cardiomyopathy [3]
- Myasthenia Gravis [5]
- Rheumatic Heart Disease [2]
Known Cross-Reactions:
Group A Streptococcus pyogens, [2]
Streptococcus mutans, [6]
streptococcal M protein, [7]
striated muscle, [5]
cytomegalovirus [8]
Clinical Significance:
As suggested in an experimental assay, [1] in which anti-myosin antibodies caused an increased calcium uptake and retention, leading to myocyte dysfunction and possibly cell death, anti-myosin antibodies may be detrimental to cardiac function. However, elevated antibodies to a-Myosin have been found in dilated cardiomyopathy pedigrees with both familial and non-familial disease, and thus do not support the concept of playing a primary pathogenic role. [4] These antibodies are more likely to be used as a marker for predisposition. [3] A high percentage of asymptomatic relatives of patients with dilated cardiomyopathy also have elevated antibodies to myosin-alpha [3] and should be monitored for early signs of autoimmune myocarditis. Due to cross reactivity, patients with Rheumatic Fever or Myasthenia Gravis should be assessed for autoimmune myocarditis.
References:
1. Bick, et al. Effects of IgM from rheumatic fever patients on intracellular calcium levels of neonatal rat cardiac myocytes. Life Sci, 2003; 73:2101-2111.
2. Fae, et al. Mimicry in recognition of cardiac myosin peptides by heart-intralesional T cell clones from rheumatic heart disease. J Immunol, 2006; 176:5662-5670.
3. Goldman, et al. Autoimmunity to a myosin in a subset of patients with idiopathic dilated cardiomyopathy. Br Heart J, 1995; 75:598-603.
4. Herskowitz, et al. Concepts of autoimmunity applied to dilated cardiomyopathy. J Am Coll Cardiol, 1993; 22:1385-1388.
5. Williams, et al. Serum antibodies and monoclonal antibodies secreted by thymic B-cell clones from patients with Myasthenia Gravis define striational antigens. Ann N Y Acad Sci, 1987; 505(1):168-179.
6. Ackermans, et al. Anti-IgG antibodies in rheumatic diseases cross-react with Streptococcus mutans SR antigen. Clin Exp Immunol, 1991; 85:265-269.
7. Quinn, et al. Immunological relationship between the class I epitope of streptococcal M protein and myosin. Infect Immun, 1998; 66(9):4418-4424.
8. Lawson, et al. Mouse cytomegalovirus infection induces antibodies which cross-react with virus and cardiac my
What does it mean if your Alpha-Myosin result is too high?
As suggested in an experimental assay, [1] in which anti-myosin antibodies caused an increased calcium uptake and retention, leading to myocyte dysfunction and possibly cell death, anti-myosin antibodies may be detrimental to cardiac function. However, elevated antibodies to a-Myosin have been found in dilated cardiomyopathy pedigrees with both familial and non-familial disease, and thus do not support the concept of playing a primary pathogenic role. [4] These antibodies are more likely to be used as a marker for predisposition. [3] A high percentage of asymptomatic relatives of patients with dilated cardiomyopathy also have elevated antibodies to myosin-alpha [3] and should be monitored for early signs of autoimmune myocarditis. Due to cross reactivity, patients with Rheumatic Fever or Myasthenia Gravis should be assessed for autoimmune myocarditis.
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What does it mean if your Alpha-Myosin result is too low?
The Alpha-Myosin marker in the Array 5 Multiple Autoimmune Reactivity Screen is considered optimal even when it is below the reference range because the interpretation of results often depends on the context of the reference range and clinical significance of the marker rather than the raw numerical value alone. Here’s why this may occur:
-
Clinical Relevance of Low Alpha-Myosin Antibodies:
- Low levels of Alpha-Myosin antibodies may indicate minimal or no autoimmune activity targeting heart muscle proteins. In this context, being below the reference range can be seen as a positive outcome and not a cause for concern.
-
Reference Range vs. Optimal Range:
- Reference ranges are derived from population studies and include a range of values seen in healthy and at-risk individuals.
- The optimal range often reflects values associated with the lowest risk of disease or dysfunction. Even if a marker is below the reference range, it may still fall within what is deemed optimal for health.
-
Autoimmune Implications:
- Elevated levels of Alpha-Myosin antibodies are associated with autoimmune activity affecting cardiac tissues, such as in myocarditis. When levels are low, this may indicate no active autoimmunity involving heart tissue, which aligns with an optimal health state.
-
Lack of Pathological Significance for Low Levels:
- For certain markers, including Alpha-Myosin, low antibody levels may not have any clinical significance or indicate a disease state. Therefore, they are marked as optimal because no further investigation or intervention is typically required.
-
Customized Interpretation:
- Results are interpreted in the context of the individual’s overall health, symptoms, and other lab markers. If there are no clinical signs of heart-related autoimmune activity, the low Alpha-Myosin level is likely considered a healthy finding.
If you have additional concerns or need further clarification, consulting the healthcare provider who ordered the test can provide personalized insights based on the patient's medical history.
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